An NHS consultant in Glasgow. Andrew Goddard, RCP president, said recruiters needed to be sure there was no conscious or unconscious bias while appointing consultancy posts.
Photograph: Murdo Macleod for the Guardian

The NHS has been embroiled in a new racism controversy after it emerged that white doctors were much more likely than black or minority ethnic medics to be promoted to consultant level.

Research led by the Royal College of Physicians (RCP) found that although white British doctors apply for fewer posts when seeking to become consultants, they were both more likely to be shortlisted than BME colleagues and also more likely to be offered a job.

The findings, coming weeks after the NHS admitted that black doctors were paid on average £10,000 less than white colleagues, prompted claims that BME doctors hoping to achieve consultant status were being discriminated against because of an “unacceptable racial bias” in appointments.

A survey of 487 doctors who became consultants in the NHS across the UK last year found stark differences in the experiences of white and BME candidates, who, having obtained a certificate of completion of training, then sought a job as a consultant (usually in their late 30s, looking, for example, for senior hospital doctor posts).

White British doctors applied for an average of 1.29 consultant posts before being hired, compared to applicants from a BME background, who applied for 1.66 posts before succeeding.

Of white medics, 80% were shortlisted compared to 66% of those from all other ethnic groups. And while 77% of white doctors succeeded in landing their first role as a consultant, just 57% of those from all other ethnic groups did so. Female BME doctors appeared to suffer a particular disadvantage when applying, the survey found.

Chaand Nagpaul, council chairat the British Medical Association, the union that represents about 70% of Britain’s 240,000 doctors, said: “This study is further confirmation of the unacceptable racial bias that exists within the NHS, and the barriers to progression faced by many black, Asian and minority ethnic doctors..

“Not only is this iniquitous, it is denying dedicated capable doctors from achieving their best in the NHS for the benefit of patients. Appointment to consultant posts should be based on merit alone so that patients can receive the highest standard of care possible from the most capable doctors.”

The RCP, which represents hospital doctors in England, said that “unconscious bias” within appointments panels could be leading to talented BME doctors being overlooked for promotion to the level of consultant. Andrew Goddard, its president, said an overhaul of consultant recruitment was urgently needed to give non-white medics a fair chance.

It is the third year in a row that the same survey has found the same wide gap between BME and white doctors’ chances of being interviewed for, and then landing, consultant posts.

The British Association of Physicians of Indian Origin claimed that BME doctors were the victims of “established racism” within the NHS.

“This result demonstrates that sadly inherent bias and discrimination continue to exist at many levels in how consultants are appointed. Calling it unconscious bias simply gives legitimacy to established racism within the system,” said Dr JS Bamrah, the association’s chair and senior psychiatrist in the health service. “Clearly, equality and diversity training is not fit for purpose, so there is a need to look at more effective ways of eliminating such bias, as this is sapping the morale of BME doctors, many of whom provide a sterling service in the NHS.”

Goddard said: “These findings are a clear warning signal that we need to investigate further and take immediate action. It is imperative that we do everything we can to make sure the appointment of consultants is based solely on ability. Discrimination, conscious and unconscious, is an issue across our society. The NHS is no exception.”

RCP representatives on advisory appointments committees, which choose which medics get invited for interview to become a consultant, will all now receive equality and diversity training “to help them understand unconscious bias, and how cultural differences impact on both performance at interview and how that performance is assessed”, the report containing the findings says.

The report was published by the RCP and its sister organisations, the Royal College of Physicians of Edinburgh, and the Royal College of Physicians and Surgeons of Glasgow.

However, Goddard said the findings were not necessarily evidence of racial prejudice. “Association is not causation. But we need to reassure ourselves that there’s no conscious or unconscious bias going on here.” RCP members of appointments committees reflected medicine in terms of their gender and ethnic split, he added.

But other leading NHS figures said the revealed disparities did show discrimination. Danny Mortimer, chief executive of NHS Employers, which represents hospital trusts in England, said the report underscored “the urgent need to address racial and gender inequality in the NHS”.